<extend name="Include:Layout"/>
<block name="title">课程预约</block>
<block name="style">
<style>

</style>
</block>

<block name="main">
	<div class="weui_tab">
		<div class="weui_navbar">
			<div class="toolbar">
		        <div class="toolbar-inner">
		            <a href="javascript:history.go(-1);" class="picker-button close-popup">返回</a>
		            <!--<h1 class="title" id="banji_title"></h1>-->
		        </div>
		    </div>
		</div>
		<div class="weui_tab_bd container" id="container">
			<div class="weui_cells" style="background:#fff;margin-top:20px;">
				<div class="weui_cell">
		            <div class="weui_cell_hd"><label class="weui_label">学生姓名</label></div>
		            <div class="weui_cell_bd weui_cell_primary">
		                <input class="weui_input" type="text" placeholder="请输入学生姓名">
		            </div>
		        </div>
		        <div class="weui_cell">
		            <div class="weui_cell_hd"><label class="weui_label">家长手机</label></div>
		            <div class="weui_cell_bd weui_cell_primary">
		                <input class="weui_input" type="number" pattern="[0-9]*" placeholder="请输入验证码">
		            </div>
		        </div>
		        <div class="weui_cell">
			        <div class="weui_cell_hd"><label for="" class="weui_label">学生生日</label></div>
			        <div class="weui_cell_bd weui_cell_primary">
			          <input class="weui_input" type="date" value="">
			        </div>
			    </div>
		    </div>
		    <div class="weui_btn_area">
		        <a class="weui_btn weui_btn_primary" href="javascript:;">确定提交</a>
		    </div>
		    <p style="color:red;padding:20px 15px;">
		    	注：试听课只支持非会员，每人仅一次免费体验机会，如本人是第二次上体验课请在前台缴纳单次课时费用。
		    </p>
		    
		   <div class="weui_btn_area">
		        <a class="weui_btn weui_btn_warn" href="javascript:;">直接报名</a>
		    </div>
		</div>
	</div>
 
</block>

<block name="script">
<script>
$(function () {
	
    
});
</script>
</block>